Risk factors for delirium after major trauma

Angles, Erik M.; Robinson, Thomas N.; Biffl, Walter L.; Johnson, Jeff; Moss, Marc; Tran, Zung V.; Moore, Ernest E.

doi:10.1016/j.amjsurg.2008.07.037

« Previous Next »The American Journal of Surgery
Volume 196, Issue 6 , Pages 864-870, December 2008

Risk factors for delirium after major trauma

Erik M. Angles, B.S.
- Department of Surgery, University of Colorado at Denver, Health Sciences Center, 12631 East 17th Ave., Mail Stop C313, PO Box 6511, Aurora, CO, USA
Thomas N. Robinson, M.D.
- Department of Surgery, University of Colorado at Denver, Health Sciences Center, 12631 East 17th Ave., Mail Stop C313, PO Box 6511, Aurora, CO, USA
- Corresponding author: Tel.: +1-303-724-2728; fax: +1-303-724-2733
Walter L. Biffl, M.D.
- Department of Surgery, University of Colorado at Denver, Health Sciences Center, 12631 East 17th Ave., Mail Stop C313, PO Box 6511, Aurora, CO, USA
- Department of Surgery, Denver Health Medical Center, Denver, CO, USA
Jeff Johnson, M.D.
- Department of Surgery, University of Colorado at Denver, Health Sciences Center, 12631 East 17th Ave., Mail Stop C313, PO Box 6511, Aurora, CO, USA
- Department of Surgery, Denver Health Medical Center, Denver, CO, USA
Marc Moss, M.D.
- Department of Medicine, University of Colorado at Denver, Health Sciences Center, Aurora, CO, USA
Zung V. Tran, Ph.D.
- Department of Biometrics, University of Colorado at Denver, Health Sciences Center, Aurora, CO, USA
Ernest E. Moore, M.D.
- Department of Surgery, University of Colorado at Denver, Health Sciences Center, 12631 East 17th Ave., Mail Stop C313, PO Box 6511, Aurora, CO, USA
- Department of Surgery, Denver Health Medical Center, Denver, CO, USA

Received 2 May 2008; received in revised form 8 July 2008

Abstract

Background

This study aimed to describe the natural history of delirium after major injury, to identify risk factors that predict the development of postinjury delirium, and to compare outcome measures in subjects with and without delirium.

Methods

A prospective study was performed on patients with an injury severity score of 8 or higher admitted to the trauma intensive care unit (ICU) of a level I trauma center. Patients underwent daily assessments for delirium with the Confusion Assessment Method-ICU.

Results

Sixty-nine patients (53 male) were enrolled. Delirium occurred in 41 (59%) subjects. Logistic regression found lower arrival Glasgow Coma Score (12 ± 1.0 vs 15 ± .1; P < .01), increased blood transfusions (2.8 ± .7 vs .5 ± .3; P < .01), and higher multiple organ failure score (1.2 ± .2 vs .1 ± .1; P < .01) to be the strongest predictors for developing delirium. Outcome measures revealed subjects with delirium had longer hospital stays, longer ICU stays, and were more likely require postdischarge institutionalization.